Urinary Tract Infection due to Extended-spectrum Beta-lactamase Producing Organisms is a Risk Factor for Bacteraemia Among Patients with Type 2 Diabetes Mellitus

Authors

  • Muhammad Abdur Rahim Nephrology, BIRDEM General Hospital, Dhaka, Bangladesh
  • Shahana Zaman Cardiology, NICVD, Dhaka, Bangladesh
  • Ishrat Jahan Nephrology, BIRDEM General Hospital, Dhaka, Bangladesh
  • Samira Humaira Habib Health Economics Unit, BADAS, Dhaka, Bangladesh
  • Tabassum Samad Nephrology, BIRDEM General Hospital, Dhaka, Bangladesh
  • Tufayel Ahmed Chowdhury Nephrology, BIRDEM General Hospital, Dhaka, Bangladesh
  • Shudhanshu Kumar Saha Nephrology, BIRDEM General Hospital, Dhaka, Bangladesh
  • Abdul Latif Nephrology, BIRDEM General Hospital, Dhaka, Bangladesh
  • Mohammad Mehfuz E Khoda Nephrology, BIRDEM General Hospital, Dhaka, Bangladesh
  • Md Mostarshid Billah Nephrology, BIRDEM General Hospital, Dhaka, Bangladesh
  • Mehruba Alam Ananna Nephrology, BIRDEM General Hospital, Dhaka, Bangladesh
  • Sarwar Iqbal Health Economics Unit, BADAS, Dhaka, Bangladesh

DOI:

https://doi.org/10.3329/bjm.v31i1.44747

Keywords:

Bacteraemia, extended-spectrum beta-lactamase, pyelonephritis, risk factor, type 2 diabetes mellitus, urinary tract infection

Abstract

Introduction: Urinary tract infection (UTI) is common among patients with diabetes mellitus and the aetiological agents are often extended-spectrum beta-lactamase (ESBL) producing bacteria. Diabetic patients with UTI are sometimes complicated by bacteraemia. This study was designed to evaluate whether UTI due to ESBL-positive organisms is a risk factor for bacteraemia among patients with type 2 diabetes mellitus.

Methods: This was a cross-sectional analytical study, done in BIRDEM General Hospital, Dhaka, Bangladesh from January to April 2016. Adult (eā€18 years) type 2 diabetic subjects of either sex with culture proven UTI were included in this study. All study participants were subjected to undergo blood cultures as well. ESBL-positivity of the infective organisms for UTI was evaluated as possible risk factor for bacteraemia.

Results: Total patients were 145 including 119 (82%) females. Eshcerichia coli (112, 77.2%) was the most common aetiological agents followed by Klebsiella pneumoniae (28, 19.3%). In 54 (37.2%) patients UTI was due to ESBL-positive organisms. Ten (6.9%) patients were complicated by bacteraemia [7 (7/ 54, 13%) among patients with UTI due to ESBL-positive organisms and 3 (3/91, 3.3%) among patients with UTI due to non-ESBL organisms]. UTI due to ESBL-positive organisms appeared as a significant risk factor for bacteraemia (OR 4.37, 95% CI 1.08-17.38, p 0.03).

Conclusion: Nearly two-fifths of UTI cases were due to ESBL-positive organisms in this study. ESBLpositivity of the causative organisms was a significant risk factor for bacteraemia among type 2 diabetic subjects.

Bangladesh J Medicine Jan 2020; 31(1) : 9-12

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Published

2019-12-30

How to Cite

Rahim, M. A., Zaman, S., Jahan, I., Habib, S. H., Samad, T., Chowdhury, T. A., Saha, S. K., Latif, A., Khoda, M. M. E., Billah, M. M., Ananna, M. A., & Iqbal, S. (2019). Urinary Tract Infection due to Extended-spectrum Beta-lactamase Producing Organisms is a Risk Factor for Bacteraemia Among Patients with Type 2 Diabetes Mellitus. Bangladesh Journal of Medicine, 31(1), 9ā€“12. https://doi.org/10.3329/bjm.v31i1.44747

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